王美洁,时亚杰,杨鹏,王建军,李迎寅,崔健,张校明.重复经颅磁刺激或无抽搐电休克治疗联合抗抑郁药物对重度抑郁障碍的疗效和安全性[J].四川精神卫生杂志,2024,37(2):108-113.Wang Meijie,Shi Yajie,Yang Peng,Wang Jianjun,Li Yingyin,Cui Jian,Zhang Xiaoming,Efficacy and safety profile of repetitive transcranial magnetic stimulation versus modified electroconvulsive therapy in combination with antidepressants in patients with major depressive disorder[J].SICHUAN MENTAL HEALTH,2024,37(2):108-113
Efficacy and safety profile of repetitive transcranial magnetic stimulation versus modified electroconvulsive therapy in combination with antidepressants in patients with major depressive disorder
DOI:10.11886/scjsws20230917002
English keywords:Major depressive disorder  Repetitive transcranial magnetic stimulation  Modified electroconvulsive therapy  Efficacy  Safety
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Author NameAffiliationPostcode
Wang Meijie Jining Medical University Jining 272051 China 272051
Shi Yajie Shandong Daizhuang Hospital Jining 272051 China 272051
Yang Peng Shandong Daizhuang Hospital Jining 272051 China 272051
Wang Jianjun Shandong Daizhuang Hospital Jining 272051 China 272051
Li Yingyin Jining Medical University Jining 272051 China 272051
Cui Jian Shandong Daizhuang Hospital Jining 272051 China 272051
Zhang Xiaoming Shandong Daizhuang Hospital Jining 272051 China 272051
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      Background Major depressive disorder is one of the most disabling mental diseases. Currently, medication in combination with physiotherapy and psychotherapy remains the most commonly used treatment modality for the disease, whereas only a few randomized controlled studies have been conducted on physiotherapy, and even fewer studies have focused on medication combined with physiotherapy.Objective To explore the efficacy and safety profile of repetitive transcranial magnetic stimulation (rTMS) versus modified electroconvulsive therapy (MECT) in combination with antidepressants in the treatment of major depressive disorder, so as to provide an optimized treatment plan for patients with major depressive disorder.Methods Patients with major depressive disorder (n=335) hospitalized in Shandong Daizhuang Hospital from January 1, 2019 to April 30, 2023 were included, all of whom met the diagnostic criteria of the International Classification of Diseases, tenth edition (ICD-10). Depending on their disease condition, patients were subjected to either MECT in combination with drugs (n=141) or rTMS in combination with drugs (n=194) after admission. Depressive symptoms were assessed using Hamilton Depression Scale-24 item (HAMD-24) at the baseline and the end of the 1st, 2nd, 3rd and 4th week of treatment, and the adverse reactions were documented in patient's medical records.Results Analysis of variance on HAMD-24 revealed a significant effect of time (F=3.081, P=0.042), but no effect of group (F=1.023, P=0.313), and the interaction effect between the time and the groups was not statistically significant (F=1.642, P=0.191). No statistical difference was reported between two groups in response rate and full remission rate (P>0.05). Throughout the course of treatment, 58 cases (41.13%) of recent memory impairment and 74 cases (52.48%) of headache or neck muscle pain occurred in MECT combined with drugs group, and 27 cases (13.92%) in rTMS combined with drugs group experienced headache or head skin discomfort.Conclusion Antidepressants in combination with rTMS or MECT show equivalent efficacy in the treatment of major depressive disorder, while rTMS combined with antidepressants demonstrates a superior safety profile compared to MECT.
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